Provider Demographics
NPI:1134814619
Name:ZORIN, ELENA BROYDE (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:ELENA
Middle Name:BROYDE
Last Name:ZORIN
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 IDLEWILD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3507
Mailing Address - Country:US
Mailing Address - Phone:858-752-7046
Mailing Address - Fax:
Practice Address - Street 1:928 FORT STOCKTON DR STE 213
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1890
Practice Address - Country:US
Practice Address - Phone:619-215-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19631171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist